Mute postseizure patient: an unusual manifestation of Todd's phenomenon

Patients who manifest neurologic deficits after a seizure can present an interesting challenge to emergency physicians, particularly when the deficits are not those normally associated with Todd's phenomenon. Although Todd's phenomenon is known to result in a wide variety of transient focal deficits, we find no case report in the medical literature of this entity resulting in mutism. We present a case of a 51-year-old woman with transient mutism and hemiparesis caused by Todd's phenomenon. We also review some of the neuroanatomic and neurophysiologic issues relating to the etiology of Todd's phenomenon, as well as alternative management strategies.